Family Practice Vol. 20, No. 6, 670-674
© Oxford University Press 2003, all rights reserved
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Family practitioners' attitudes and knowledge about irritable bowel syndrome
Effect of a trial of physician education
Kaiser Permanente Medical Care Program, Department of Gastroenterology, San Diego, CA and Department of Research and Evaluation, Pasadena, CA, USA
Correspondence to George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Center; 4647Zion Avenue, San Diego, CA 92120, USA; Email: George.F.Longstreth{at}kp.org
Background. Primary physicians care for most patients with irritable bowel syndrome (IBS), but data on their attitudes and knowledge about the disorder are limited to research in the UK.
Objective. The purpose of the present study was to assess US family practitioners' attitudes and knowledge about IBS and determine the effect of a single education class on these measures.
Methods. In a large health maintenance organization (HMO), a baseline group of family practitioners twice completed a questionnaire on attitudes and knowledge about IBS, 3 months apart. A class group completed it pre-class, immediately post-class and 3 months post-class.
Result. Thirty-five physicians ranked IBS among five chronic, painful syndromes as highest in difficulty satisfying patients, tied with headache for highest in difficulty in practice strategy decision, second in time required, and fourth in diagnostic confidence and satisfaction in caring for patients. IBS and heartburn had widely separated rankings in all five attitudes. The correct answer rate on seven of 13 knowledge questions was <50%, and a majority did not identify the Rome II symptom criteria as typical and lacked other important knowledge. Of the 30 class physicians, the knowledge scores (mean ± SD; maximum possible, 13) of 29 increased from 5.59 ± 1.84 pre-class to 10.21 ± 1.76 immediately post-class (P < 0.0001); 3 months later, the scores were lower (8.93 ± 0.36) than post-class (P < 0.0001), but still higher than pre-class (P < 0.0001). Their attitude rankings were nearly identical pre-class and 3 months later (P > 0.05). In the 19 baseline physicians, IBS attitude rankings and knowledge scores did not change significantly over 3 months (P > 0.05).
Conclusion. These US family practitioners had attitudes about IBS patients and lacked knowledge that could interfere with patient care. A single class improved short-term knowledge but had little effect on attitudes about IBS.
Keywords. Irritable bowel syndrome, physician attitude, physician education, physician knowledge.
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